| NPI | 1356496632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 282401) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: HI 17934) |
| 208000000X Pediatrics (Licence: CA C153623) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-07-29 |